Exercise-Induced Vasculitis: A Review with Illustrated Cases.

Although exercise-induced vasculitis (EIV) is usually misdiagnosed, it is not uncommon. Occurring mostly after prolonged exercise, especially in hot weather, EIV is an isolated cutaneous vasculitis with stereotypical presentation. This article reviews the clinical characteristics, treatments, and outcomes of EIV based on the published literature.

Thrombin Generation Assay in Hospitalized Nonsurgical Patients: A New Tool to Assess Venous Thromboembolism Risk?

Background: Assessment of venous thromboembolism (VTE) risk is important to determine optimal primary prophylaxis in hospitalized patients. The Padua score helps to recognize patients with high VTE risk, but quantifying a VTE risk is often challenging in medical patients. Thrombin generation assay (TGA) reflects the pro-/anticoagulant balance and thus could help to better quantify VTE risk in medical hospitalized patients.

Effect of Extrinsic and Intrinsic Stressors on Clinical Skills Performance in Third-Year Medical Students.

Background: Both enhancements and impairments of clinical performance due to acute stress have been reported, often as a function of the intensity of an individual's response. According to the broader stress literature, peripheral or extrinsic stressors (ES) and task-contingent or intrinsic stressors (IS) can be distinguished within a stressful situation. The objective of this study was to assess the impact of IS and ES on clinical performance.

e-Learning versus lecture-based courses in ECG interpretation for undergraduate medical students: a randomized noninferiority study.

Objective: An ECG is pivotal for the diagnosis of coronary heart disease. Previous studies have reported deficiencies in ECG interpretation skills that have been responsible for misdiagnosis. However, the optimal way to acquire ECG interpretation skills is still under discussion.

[Validation of a screening tool toward a geriatric comprehensive assessment during a non geriatric consultation: the geriatric warning test].

Comprehensive geriatric assessment (CGA) is a validated method but is time consuming and must be performed by several professional. It is useful to elaborate a screening tool, which allows the elderly to CGA. The aim of this study is to validate the Geriatric Warning Test (GWT), a 6-questions form: 1) Did your patient consult or did hospitalize for a fall in the last 3 months? 2) Did your patient lose weight or did he loose the appetite? 3) Has your patient difficulties to see or listen? 4) Does your patient need help in the everyday life? 5) Has your patient a change of the cognitive functions? 6) Does your patient need a geriatric evaluation for one or several any reason that those cited previously? During a prospective observational study, a doctor non-geriatrician practitioner informed the GWT during a consultation of vascular medicine.

Stress responses in medical students in ambulatory and in-hospital patient consultations.

Context:  Little is known about health professionals' responses to acute stressors encountered in the clinical environment. The goal of this study was to measure the subjective and physiological stress responses of medical students to consultations in familiar (in-hospital) and unfamiliar (ambulatory) settings. We hypothesised that: (i) providing a consultation in an unfamiliar setting would result in increased stress responses in medical students, and (ii) some differences in stress responses according to gender might become apparent.

Exploring how students think: a new method combining think-aloud and concept mapping protocols.

Objectives: A key element of medical competence is problem solving. Previous work has shown that doctors use inductive reasoning to progress from facts to hypotheses and deductive reasoning to move from hypotheses to the gathering of confirmatory information. No individual assessment method has been designed to quantify the use of inductive and deductive procedures within clinical reasoning.

Lethal limb ischaemia in leukaemia. Case report and review of the literature.

Several disturbances of the coagulation system are associated with malignancies of the hematopoietic system. The primary mechanisms of these are disseminated intravascular coagulation and hyperviscosity. As such, bleeding or thrombotic events are often encountered and, occasionally, they may even be the inaugural symptom of leukaemia.

D-dimers, thrombin-antithrombin complexes, and risk factors for thromboembolism in hospitalized patient.

Introduction: There is lack of data about the correlation between hemostatic markers and the clinical and biological risk factors (RFs) for venous thromboembolism (VTE) in medical inpatients without suspicion of acute VTE.

Material And Methods: To evaluate the coagulation activation status in patients with current known RFs for VTE, the authors measured 2 markers of hypercoagulability, thrombin antithrombin (TAT) complexes and D-dimers, at day 1 in 165 patients hospitalized in internal medicine wards without suspected acute VTE. All known RFs for VTE were systematically assessed at admission and classified in a chronological way as permanent or transient.

[Abdominal aortic involvement in active giant cell (temporal) arteritis: a study of 20 patients by Doppler ultrasonography and computed tomographic angiography].

Objective: This study used Doppler ultrasonography and computed tomographic angiography (CTA) to assess the prevalence of abdominal aortic lesions that suggested abdominal aortitis at diagnosis of giant-cell or temporal arteritis (GCA). We also evaluated the contribution of these 2 techniques to diagnosis.

Methods: This single-center study included patients admitted to the internal medicine department of the Nantes (France) University Hospital, between May 1999 and May 2002 at the time of their diagnosis with biopsy-proven GCA.

Aortic involvement in recent-onset giant cell (temporal) arteritis: a case-control prospective study using helical aortic computed tomodensitometric scan.

Objective: The prevalence of the involvement of large vessels in giant cell arteritis (GCA) is 3-13%. Aortitis is the most serious complication of GCA. Computed tomodensitometric (CT) scan allows analysis of both the aortic wall and endoluminal part of the aorta.

Acute posttraumatic ischemia of the limbs: algodystrophy or related syndrome? A prospective study on a series of 25 patients.

The aim of this study was to present clinical and paraclinical features of a rarely studied vascular syndrome that usually occurs after a minor traumatic injury. The prospective study of 25 patients identified a group of young subjects, mainly women, generally with history of vascular hyperactivity to cold, showing disseminated pain in a limb always combined with vasospasm, consecutive to a minor traumatic injury in general, and simulating acute ischemia of a limb. The patients' arterial and microcirculatory flows were restored after warming, which proved that they were suffering from intense, reversible but pathological vasospasm, because of its duration, diffusion, intensity, and disproportion as to the triggering event.

Buttock claudication disclosing a thrombosis of the superior left gluteal artery: Report of a case diagnosed by a selective arteriography of the iliac artery, and cured by per-cutaneous stenting.

We report on a case of left buttock claudication, occurring consistently after 150 meters walking, and disappearing after a short rest. As magnetic resonance angiography (MRA) did not show any explanation for this claudication, a selective angiography of left internal iliac artery was requested, which clearly identified a tight stenosis of the onset of the left superior gluteal artery. A per-cutaneous angioplasty together with stenting of this artery, induced a prompt and complete relief of pain at the three months follow-up visit.

[Risk factors for maternal thromboembolism: clinical predisposition].

Predisposing clinical features in pregnant women are poorly evaluated in the literature. Several factors are undeniable, for example extrinsic compression of the iliac vein (Cockett syndrome), post phlebitis disease, varicose vein disease, and, for most patients, unquantifiable risk factors. Careful assessment of the overall sensitivity to venous thrombosis, on the basis of history taking (patient and family), will allow better assessment of the predisposition to thromboembolism.

Development of an experimental model of pre-thrombosis in rats based on Wessler's principle using a calibrated venous stasis.

We have developed a model of a pre-thrombotic state in rats based on venous stasis induced by partial ligature of the inferior vena cava. The degree of stenosis was calibrated by using variations in upstream venous pressure. Different degrees of stasis were tested in order to obtain a pre-thrombotic state.